Thyroid eye disease is an inflammation of the orbital tissues (muscles and fat around the eye) associated with thyroid disorders, most often Graves' disease. It can change the appearance of the eyes and, in severe forms, threaten vision.
The signs
Exophthalmos (the eye seems to "bulge"), upper eyelid retraction giving a staring look, eyelid swelling and redness, dry eye, sometimes double vision. Loss of vision or intense pain requires urgent consultation.
Medical management
It relies first on balancing the thyroid with the endocrinologist and on stopping smoking, which strongly worsens the disease. Eye lubricants are added and, in active forms, anti-inflammatory treatment. Upper eyelid retraction can also be eased by botulinum toxin injections into the Müller muscle, performed by Dr Prud'homme. Regular ophthalmological monitoring is essential.
Surgery
It is considered once the inflammatory phase has settled, in a precise order: orbital decompression if needed, eye muscle surgery in case of double vision, then eyelid surgery (retraction repair). Dr Prud'homme handles the eyelid part of this care, in coordination with the endocrinologist and the specialised teams.
Frequently asked questions
Does smoking really worsen the disease?
Yes — it is the main avoidable aggravating factor: it increases the risk of severe disease and reduces treatment effectiveness. Stopping smoking is an integral part of the treatment.
Can exophthalmos regress?
Inflammation often subsides with treatment and time, but established exophthalmos may persist: it is then addressed by decompression surgery, performed once the disease is quiet.
Book an appointment
Consultations in Boulogne-Billancourt (Ophtalife) and Saint-Maur-des-Fossés (Beaurepaire).